D-penicillamine-induced membranous nephropathy

Kumar, RP Senthil; Prasad, ND Srinivasa; Tirumavalavan, S; Fernando, M Edwin

doi:10.4103/0971-4065.132024

Cited by 7 publications

(5 citation statements)

References 4 publications

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“…There are many side effects of penicillamine, with rash, loss of appetite, nausea, diarrhea and leucopenia being the most common, whereas nephropathy, hepatotoxicity, aplastic anemia [ 8 ], antibody-mediated myasthenia gravis [ 9 ], Lambert–Eaton myasthenic syndrome and drug-induced systemic lupus erythematosus [ 10 ] are some other possible adverse reactions. Proteinuria and nephrotic syndrome are the most commonly encountered features of renal pathology [ 11 , 12 , 13 ]. Proteinuria is the most common kidney-related adverse reaction due to penicillamine, with MN being the most common histological pattern, followed by MCD [ 11 , 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Proteinuria and nephrotic syndrome are the most commonly encountered features of renal pathology [ 11 , 12 , 13 ]. Proteinuria is the most common kidney-related adverse reaction due to penicillamine, with MN being the most common histological pattern, followed by MCD [ 11 , 12 , 13 ]. No appreciable changes to renal function have been noted.…”

Section: Discussionmentioning

confidence: 99%

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Drug-Induced Podocytopathies: Report of Four Cases and Review of the Literature

Athanasopoulou

Lionaki

Skalioti

et al. 2023

Life

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Kidney injury due to medications is a well-known clinical entity. Although drug-induced tubulointerstitial disease is commonly encountered, there are few reports in the literature associated with glomerular injury due to medications. The recognition of this type of kidney injury is crucial, as rapid discontinuation of the offending agent is critical to maximizing the likelihood of quick and effective renal function recovery. In this article, we present four cases that presented with nephrotic syndrome and were diagnosed with biopsy-proven podocytopathies, associated with exposure to a certain medication. All of them experienced complete resolution of nephrotic syndrome within days or weeks after discontinuation of the offending drug. We also present the data, which were found in a Medline search from the year 1963 until the present, regarding cases with podocytopathies associated with penicillamine, tamoxifen and the combination of pembrolizumab-axitinib, including only adult cases from the English literature. The Medline search revealed nineteen cases of penicillamine-induced minimal-change disease (MCD), one case of tamoxifen-induced MCD, and none associated with pembrolizumab-axitinib therapy. We also searched for the largest studies and meta-analyses regarding drug-induced podocytopathies after a Medline search from 1967 to the present of the English literature.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Drug-Induced Podocytopathies: Report of Four Cases and Review of the Literature

Athanasopoulou

Lionaki

Skalioti

et al. 2023

Life

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“…The spectrum of histopathological changes in penicillamine-induced nephropathy includes membranous nephropathy (80%), lupus nephritis, tubulointerstitial nephritis, minimal change disease, crescentic glomerulonephritis, Goodpasture syndrome and renal-limited vasculitis. 4 Penicillamine-induced antineutrophil cytoplasmic antibody-associated vasculitis in children has also been described. 5 DIL is an autoimmune condition that results from drug exposure and presents with clinical features of SLE.…”

Section: Discussionmentioning

confidence: 99%

“…The proteinuria usually begins 6 months to 1 year after initiation of therapy with penicillamine. The spectrum of histopathological changes in penicillamine‐induced nephropathy includes membranous nephropathy (80%), lupus nephritis, tubulointerstitial nephritis, minimal change disease, crescentic glomerulonephritis, Goodpasture syndrome and renal‐limited vasculitis 4 . Penicillamine‐induced anti‐neutrophil cytoplasmic antibody–associated vasculitis in children has also been described 5 …”

Section: Discussionmentioning

confidence: 99%

Proteinuria in a 6‐year‐old girl with Wilson disease: Lessons learnt

Narayan

Karunakar

Krishnamurthy

et al. 2022

J Paediatrics Child Health

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“…These antibodies are prevalent in primary membranous glomerulonephritis in up to 68.5% of cases and their absence on the face of renal biopsy picture of membranous nephropathy suggests the secondary cause of membranous glomerulonephritis[ 71 ]. Kumar et al [ 72 ] reported nephrotic syndrome in a 24-year-old lady, a case WD on D-penicillamine for 18 mo. Renal biopsy showed membranous nephropathy with positive immunofluorescence for IgG and C3, and with negative serum auto-antibodies to M-type phospholipase A2 receptor (MPLA 2 R, which is usually seen in primary membranous nephropathy), thus supporting the diagnosis of secondary membranous glomerulonephritis.…”

Section: Management Difficultiesmentioning

confidence: 99%

Challenges and dilemmas in pediatric hepatic Wilson’s disease

Ghosh,

Sen Sarma,

Samanta

2023

World J Hepatol

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Patients with liver cirrhosis are advised to limit their sodium consumption to control excessive fluid accumulation. Salt is the most common form in which sodium is consumed daily. Consequently, various recommendations urge patients to limit salt intake. However, there is a lack of consistency regarding salt restriction across the guidelines. Moreover, there is conflicting evidence regarding the efficacy of salt restriction in the treatment of ascites. Numerous studies have shown that there is no difference in ascites control between patients with restriction of salt intake and those without restriction. Moreover, patients with cirrhosis may have several negative effects from consuming too little salt, although there are no recommendations on the lower limit of salt intake. Sodium is necessary to maintain the extracellular fluid volume; hence, excessive salt restriction can result in volume contraction, which could negatively impact kidney function in a cirrhotic patient. Salt restriction in cirrhotic patients can also compromise nutrient intake, which can have a negative impact on the overall outcome. There is insufficient evidence to recommend restricted salt intake for all patients with cirrhosis, including those with severe hyponatremia. The existing guidelines on salt restriction do not consider the salt sensitivity of patients; their nutritional state, volume status and sodium storage sites; and the risk of hypochloremia. This opinion article aims to critically analyze the existing literature with regard to salt recommendations for patients with liver cirrhosis and identify potential knowledge gaps that call for further research.

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D-penicillamine-induced membranous nephropathy

Cited by 7 publications

References 4 publications

Drug-Induced Podocytopathies: Report of Four Cases and Review of the Literature

Drug-Induced Podocytopathies: Report of Four Cases and Review of the Literature

Proteinuria in a 6‐year‐old girl with Wilson disease: Lessons learnt

Challenges and dilemmas in pediatric hepatic Wilson’s disease

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